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1 Asia Pacific Journal of Clinical Nutrition
       Volume 17, 2

         (June 2008)


Abstracts

Contents

Abstract Papers

Review Articles

HPV-induced recurrent laryngeal papillomatosis: rationale for adjuvant fatty acid therapy LOUISE LOUW AND ANDR CLAASSEN

Asia Pac J Clin Nutr. 2008;17(2):187-193.

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Original Research Communications

Macro-Micro and Phyto-nutrients

Vitamins, minerals and race performance in ultra-endurance runners-Deutschlandlauf 2006

BEAT KNECHTLE, PATRIZIA KNECHTLE, INGO SCHULZE AND GTZ KOHLER

Asia Pac J Clin Nutr. 2008;17(2):194-198.

 

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Nutritional Status, Dietary Intakes, and Body Composition

Nutritional status of adults participating in ambulatory rehabilitation SUPREET KAUR, MICHELLE D MILLER, JULIE HALBERT, LYNNE C GILES AND MARIA CROTTY

Asia Pac J Clin Nutr. 2008;17(2):199-207.

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Effects of social determinants on food choice and skipping meals among Turkish adolescents

MERAL TURK SOYER, ISIL ERGIN AND SAFAK TANER GURSOY

Asia Pac J Clin Nutr. 2008;17(2):208-215.

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Diet and obesity among Chamorro and Filipino adults on Guam RACHAEL T LEON GUERRERO, YVETTE C PAULINO, RACHEL NOVOTNY AND SUZANNE P MURPHY

Asia Pac J Clin Nutr. 2008;17(2):216-222.

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Comparisons between anthropometric indices for predicting the metabolic syndrome in Japanese MASAYUKI KATO, YOSHIHIKO TAKAHASHI, MANAMI INOUE, SHOICHIRO TSUGANE, TAKASHI KADOWAKI AND MITSUHIKO NODA, FOR JPHC STUDY GROUP

Asia Pac J Clin Nutr. 2008;17(2):223-228.

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How useful is waist circumference for assessment of abdominal obesity in Korean pre-menopausal women during weight loss? MI-JA HWANG, WON-SUK CHUNG, DYMPNA GALLAGHER, DEOG-YOON KIM, HYUN-DAE SHIN AND MI-YEON SONG

Asia Pac J Clin Nutr. 2008;17(2):229-234.

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Energy expenditure and energy intake in 10-12 years obese and non-obese Chinese children in a Guangzhou boarding school

CAI-XIA ZHANG, YU-MING CHEN, WEI-QING CHEN, XUE-QING DENG AND ZHUO-QIN JIANG

Asia Pac J Clin Nutr. 2008;17(2):235-242.

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Growth and Child Nutrition

Partial breastfeeding protects Bedouin infants from infection and morbidity: prospective cohort study

NATALYA BILENKO, ROHINI GHOSH, AMALIA LEVY, RICHARD J DECKELBAUM AND DRORA FRASER

Asia Pac J Clin Nutr. 2008;17(2):243-249.

 

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A comparative intervention trial on fish sauce fortified with NaFe-EDTA and FeSO4+citrate in iron deficiency anemic school children in Kampot, Cambodia

PHILIPPE LONGFILS, DIDIER MONCHY, HEIKE WEINHEIMER, VISITH CHAVASIT, YUKIKO NAKANISHI AND KLAUS SCHMANN

Asia Pac J Clin Nutr. 2008;17(2):250-257.

 

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The effects of docosahexaenoic acid-rich fish oil on behavior, school attendance rate and malaria infection in school children – a double-blind, randomized, placebo-controlled trial in Lampung,Indonesia KEI HAMAZAKI, DIN SYAFRUDDIN, INSAN S TUNRU, MARINA F AZWIR, PUJI BS ASIH, SHIGEKI SAWAZAKI AND TOMOHITO HAMAZAKI Asia Pac J Clin Nutr. 2008;17(2):258-263.

 

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Effect of iron fortification of nursery complementary food on iron status of infants in the DPRKorea HUIYONG RIM, SUHUAN KIM, BYONGCHEL SIM, HAEYONG GANG, HOYONG KIM, YONGRAN KIM, RAKCHEL KIM, MUNHUI YANG AND SANGPIL KIM Asia Pac J Clin Nutr. 2008;17(2):264-269.

 

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Maternal and Women’s Nutrition

Nutrient intake risk factors of osteoporosis in postmenopausal women JEONGSEON KIM, SUN-YOUNG LIM AND JOO-HAK KIM

Asia Pac J Clin Nutr. 2008;17(2):270-275.

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Serum zinc levels amongst pregnant women in a rural block of Haryana State, India PRIYALI PATHAK, UMESH KAPIL, SADA NAND DWIVEDI AND RAJVIR SINGH Asia Pac J Clin Nutr. 2008;17(2):276-279.

 

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Aging and Elder Nutrition

Dietary supplementation by older adults in Japan FUMI HIRAYAMA, ANDY H LEE, COLIN W BINNS, FUMIKO WATANABE AND TOMOYA OGAWA Asia Pac J Clin Nutr. 2008;17(2):280-284.

 

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Prevalence of malnutrition in free living elderly people in Iran: a cross-sectional study MALIHEH ALIABADI, MASOOD KIMIAGAR, MAJID GHAYOUR-MOBARHAN, MOHAMMAD TAGHI SHAKER, MOHSEN NEMATY, ALI AKBAR ILATY, AJMAD-REZA MOOSAVI AND SUE LANHAM-NEW Asia Pac J Clin Nutr. 2008;17(2):285-289.

 

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The relevance of the Heart Foundation of Australia’s dietary recommendations for adult Australians: a comparison of views of general practitioners, cardiologists and dietitians

SYLVIA POMEROY AND A WORSLEY

Asia Pac J Clin Nutr. 2008;17(2):290-296.

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Nutritional Epidemiology and Public Health

Assessing physical activity in an Asian country: Low energy expenditure and exercise frequency among adults in Taiwan JACKSON PUI MAN WAI, CHI PANG WEN, HUI TING CHAN, PO HUANG CHIANG, MIN KUANG TSAI, SHAN POU TSAI AND HSING-YI CHANG Asia Pac J Clin Nutr. 2008;17(2):297-308.

 

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A participatory assessment of dietary patterns and food behavior in Pohnpei, Federated States of Micronesia ALLISON CORSI, LOIS ENGLBERGER, RAFAEL FLORES, ADELINO LORENS AND MAUREEN H FITZGERALD

Asia Pac J Clin Nutr. 2008;17(2):309-316.

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The extent and nature of “health messages” in magazine food advertising in Australia SANDRA C. JONES, KELLY L ANDREW, LINDA TAPSELL, PETER WILLIAMS AND DANIELLE MCVIE Asia Pac J Clin Nutr. 2008;17(2):317-324.

 

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Nutritionally-Related Disorders and Diseases and Their Risk Factors

Association between C677T/MTHFR genotype and Homocysteine Concentration in a Kazakh Population AINUR AKILZHANOVA, NOBORU TAKAMURA, YOSUKE KUSANO, LUDMILA KARAZHANOVA, SHUNICHI YAMASHITA, HIROSHI SAITO AND KIYOSHI AOYAGI Asia Pac J Clin Nutr. 2008;17(2):325-329.

 

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High plasma homocysteine is associated with the risk of coronary artery disease independent of methylenetetrahydrofolate reductase 677CT genotypes PING-TING LIN, MEN-CHUNG HUANG, BOR-JEN LEE, CHIEN-HSIUNG CHENG, TSUNG-PO TSAI AND YI-CHIA HUANG

Asia Pac J Clin Nutr. 2008;17(2):330-338.

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Body mass index (BMI) as a major factor in the incidence of the metabolic syndrome and its constituents in unaffected Taiwanese from 1998 to 2002 FENG-YU YANG, MARK L WAHLQVIST AND MEEI-SHYUAN LEE Asia Pac J Clin Nutr. 2008;17(2):339-351.

 

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Nutrition and Infection

HPV-induced recurrent laryngeal papillomatosis: dietary fatty acid and micronutrient intakes LOUISE LOUW AND CORINA WALSH Asia Pac J Clin Nutr. 2008;17(2):352-357.

 

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Erratum

Asia Pac J Clin Nutr. 2008;17(2):358.

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Future Events

Asia Pac J Clin Nutr. 2008;17(2):359.

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HPV-induced recurrent laryngeal papillomatosis: rationale for adjuvant fatty acid therapy

LOUISE LOUW AND ANDR CLAASSEN

The course of human papilloma virus (HPV)-induced recurrent laryngeal papillomatosis (RLP) is variable and unpredictable.  Some patients experience spontaneous remission, while others suffer from aggressive growth with dire consequences.  Unfortunately, HPV DNA can persist in mucosa after treatment and can be reactivated under immunosuppressive conditions. For this reason, these benign tumors are notoriously recurrent.  Better understanding of lipid-driven signaling pathways during tumorigenesis and immune responses in RLP patients can contribute to improve therapeutic approaches in an attempt to obviate this disease.  Based on a mountain of evidence in the literature that concerns the immunomodulatory potential of certain FAs, it is clear that there is a rationale for adjuvant FA therapy (concurrent application) in the management of RLP.  Of particular importance for immune surveillance is that the Th1 pathway in RLP is down-regulated and it is advocated that conjugated linoleic acid (CLA) and eicosapentaenoic acid (EPA) have the ability to restore the Th1/Th2 balance.  Therefore, it is proposed that adjuvant FA therapy with CLA and EPA must be included in the therapeutical regime of RLP, since they are considered excellent anti-viral and anti-tumor agents to improve immune conditions and disease outcome.  Immunocompetence plays a pivotal role in the clinical course of RLP and, hence, a new direction with adjuvant FA therapy may be the key to prevent recurrence of this disease.

Key Words: Benign tumors, laryngeal papillomatosis, therapeutic rationale, adjuvant fatty acid therapy, nutritional immunomodulation

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人類乳突病毒誘導復發喉頭乳瘤:脂肪酸輔助治療之理論基礎

人類乳突病毒誘導復發喉頭乳瘤(RLP)的發生是多變的且不可預料的。有些病人的症狀會自動減輕,但有些病人則長出大瘤導致嚴重後果。不幸地,接受治療後,人類乳突病毒之DNA仍可持留在黏膜中且在免疫抑制的情況下,還會被活化。因此這些良性瘤會猖狂地不斷復發。了解RLP病人在致瘤過程和免疫反應中的脂質訊號路徑有助於改進此疾病的治療方法。既然脂肪酸的免疫調節功能已有佐證如山的文獻證據,顯然應用在RLP病人也是有合理的根據。在RLP中,Th1路徑被向下調節,而共軛亞麻油酸(CLA)和二十碳五烯酸(EPA)被認為能夠恢復Th1/Th2的平衡。自從它們被認為是傑出的抗病毒和抗腫瘤劑而能改善免疫情況和疾病結果後,含有CLA和EPA的脂肪酸輔助治療就被提議包含在RLP的療程內。臨床上RLP病人的免疫能力扮演著一個重要的角色,因此以脂肪酸輔助治療的新方向可能成為預防疾病復發的重要關鍵。

關鍵字:良性瘤、喉頭乳瘤、治療理論基礎、脂肪酸輔助治療、營養免疫調控

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Vitamins, minerals and race performance in ultra-endurance runners-Deutschlandlauf 2006

BEAT KNECHTLE, PATRIZIA KNECHTLE, INGO SCHULZE AND GTZ KOHLER

We investigated the effect of pre-race intake of vitamins and minerals, in the form of supplementation, before a multi-stage ultra-endurance run and their effect on race performance. At the Deutschlandlauf 2006 in Germany, where athletes had to run across Germany from the north (Kap Arkona - Rgen) to the south (Lrrach) over 1,200 km within 17 consecutive stages, twenty male ultra runners (46.2 9.6 years, 71.8 5.2 kg, 179 6 cm, BMI 22.5 1.9 kg/m2) completed a questionnaire about their intake of vitamin and mineral supplements in the four weeks before the race. Race performance of athletes with- and athletes without regular intake of these supplements were compared. In the four weeks before the run, nine runners (45%) ingested vitamin- and twelve athletes (60%) mineral supplements. Athletes with an intake of vitamins (152.8 14.1 h versus 160.6 14.6 h, p > 0.05) and minerals (151.6 14.5 h versus 165.3 10.8 h, p > 0.05) finished the race no faster than athletes without an intake of vitamins and minerals. We concluded that in the Deutschlandlauf 2006 of over 1,200 km within 17 consecutive stages, athletes with a regular intake of vitamin and mineral supplements in the four weeks before the race finished the competition no faster than athletes without an intake of vitamins and minerals.

Key Words: ultra running - supplementation - nutrition - ergogenic aids - exercise

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 極限跑者維生素及礦物質攝取及競賽表現–Deutschlandlauf 2006

本研究想探討在一個多階段極限耐力賽跑前,以補充劑的形式攝取維生素和礦物質的效果和這樣的補充對於競賽上的影響。參加德國Deutschlandlauf 2006的運動員都需要從德國北方(Kap Arkona - Rgen)橫跨到南方(Lrrach),進行超過1200公里,17個連續階段的賽跑。共20位男性跑者(46.2 9.6歲, 71.8 5.2公斤, 179 6公分, BMI=22.5 1.9 kg/m2)完成關於比賽前四週攝取維生素和礦物質補充劑的問卷。比較有規律攝取補充劑和沒有攝取補充劑的運動員之競賽表現。賽跑前四週有9位(45%)補充維生素和有12位(60%)補充礦物質。不管是攝取維生素或礦物質補充劑的運動員完成比賽並沒有比未補充的運動員來得快。所以結論是對於Deutschlandlauf 2006超過1200公里且17個連續階段的競賽而言,比賽前四週有規律攝取維生素和礦物質補充劑的運動員,完成比賽的速度並沒有快過於未補充的運動員。 關鍵字:極限賽跑、補充、營養、增進機能的輔助、運動

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Nutritional status of adults participating in ambulatory rehabilitation

SUPREET KAUR, MICHELLE D MILLER, JULIE HALBERT, LYNNE C GILES AND MARIA CROTTY

Aims: To assess the overall nutritional status of older adults participating in ambulatory rehabilitation and determine its association with relevant outcomes including physical function and quality of life. Design: Cross-sectional. Setting: Ambulatory rehabilitation service in the Southern region of Adelaide, Australia. Subjects: A total of 229 participants recruited as part of a RCT between June 2005 and June 2006, stroke (n=83), elective orthopedic procedure (n=44) and other medical condition (n=102). Methods: Nutritional status was measured using Mini Nutritional Assessment (MNA), Simplified Nutrition Appetite Questionnaire (SNAQ) and Body Mass Index. Functional performance was assessed using the Modified Barthel Index (MBI) and quality of life was measured using the Short Form-36 (SF-36). Results: Sixty-three percent of participants were malnourished or at risk of malnutrition according to the MNA and a third had a risk of ≥ 5% weight loss in the subsequent six months, according to the SNAQ. Participants with a diagnosis other than stroke or elective orthopedic procedure were the most vulnerable, with 53% (n=74/140) classified as at risk of malnutrition or malnourished and a longer length of stay in hospital. Functional performance was no different for participants assessed as at risk of malnutrition or malnourished compared to the well nourished, but the SF-36 mental component score was significantly higher for those who were well nourished (p=0.003). Conclusion: Findings emphasise the magnitude of the malnutrition problem in ambulatory rehabilitation settings. Further research is required to evaluate the resource implications against expected benefits of providing nutrition interventions at this point. Key Words: ambulatory rehabilitation, older, malnutrition, quality of life, appetite

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參加復健門診的成年人之營養狀況

目的:評估參與非臥床復健的老年人的整體營養狀況與其相關後果,包含身體功能及生活品質的相關性。設計:橫斷性研究。地點:在澳洲阿德雷德南區非臥床復健服務中心。研究對象:在2005年6月至2006年6月間總共納入229名參與者,包括中風者83位、矯形骨科手術者44位及其他醫療狀況102位。方法:營養狀況採用迷你營養評估(NMA)、簡易營養胃口問卷(SNAQ)及身體質量指數測量。採用修正的巴特爾指數(MBI)評估功能表現,採用Short Form-36(SF-36)測量生活品質。結果:根據MNA,有63%的參與者為營養不足或有營養不足的風險;根據SNAQ,在接下來的6個月,三分之一的人有體重減輕≥5%的危險性。經診斷非中風或矯形骨科手術的其他參與者,營養不足的風險較大,佔53%,而且住院日期也較長。有營養不足或有營養不足風險者與營養充足的參與者相比,在功能表現上沒有差異,但是營養充分者的SF-36心理面向分數顯著較高(p=0.003)。結論:本研究之發現強調了復健門診病人的營養不良問題之嚴重性。在提供營養介入之前,需要更進一步的研究去評估可能與預期益處相抵觸的因子。 關鍵字:復健門診、老人、營養失調、生活品質、胃口。

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Effects of social determinants on food choice and skipping meals among Turkish adolescents

MERAL TURK SOYER, ISIL ERGIN AND SAFAK TANER GURSOY

Purpose: To present data that contributes to understanding factors that influence food choice and skipping meals in adolescents. Methods: A cross sectional study is carried in selected high schools in Bornova. Study sample compromises of 527 students chosen randomly by class from a population of 2410 first year in high school students. Self-administered questionnaires containing sociodemographic determinants, self reported weight and height, food choices and meal patterns were used. Findings: A psychosocial factor that affects almost all of the students is the “taste and sensory perception of food”. The second noticable factor is the “health and nutritious value of food”. The time conserved and the convenience in the preparation of food is one of the lifestyle factors that affect more than half of the students. The cost of the food was also found to have an effect. Among the third group of factors categorized as “media”, the leading factor is advertisement, effective in one third of the students. Among boys and girls, there was no statistical difference in the type of meal skipped. Living in Izmir for more than 10 years compared to less than ten years, being in a nuclear family to extended family, and belonging to the “owner” social class to “wage laborer” class also do not statistically differ with regard to skipping meals. However, the mother’s and father’s education level and having a working mother are associated with skipping meals. Conclusions: These results provide important evidence to support opportunities to positively influence the adoption of healthful eating. Key Words: Adolescent, food choice, skipping meals, meal pattern, social determinant

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土耳其青少年中社會因子對食物選擇及略餐的影響

目的:以收集的資料呈現影響青少年食物選擇及略餐的因子。方法:在Bornova選出幾間高中執行此橫斷性研究。從2410名一年級的高中學生中隨機選取537名為研究對象。自填式的問卷包含社會人口學變項、自述體重及身高、食物選擇及餐點模式。發現:“食物的味道及感官感覺”是影響幾乎所有學生選擇食物的首要精神社會因子。第二個顯著的因子是“食物的健康與營養價值”。準備食物節省的時間與便利性則是影響一半以上的學生的生活型態因子。食物的價格也具有影響。在第三組媒體因子中,廣告是首要的因素,影響三分之ㄧ的學生。在略餐不食的型態上,男孩與女孩沒有統計顯著差異。生活在Izmir超過十年者比起少於十年者,居於核心家庭或大家庭,屬於"老闆"階層或"勞工"階層在跳餐方面都沒有統計上的差異。然而,母親及父親的教育程度和母親在外工作與跳餐有關。結論:這些結果提供了重要的證據,說明哪些因子對接受健康飲食有正面影響。 關鍵字:青少年、食物選擇、略餐、餐食模式、社會決定因子。

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Diet and obesity among Chamorro and Filipino adults on Guam

RACHAEL T LEON GUERRERO, YVETTE C PAULINO, RACHEL NOVOTNY AND SUZANNE P MURPHY

The purpose of this study was to compare the body mass index (BMI) and dietary intakes of Chamorro (n=66) and Filipino (n=61) adults, ages 25-65 years, living in Guam. Participants were recruited via community-based sampling; however, recruitment was targeted to ensure approximately equal numbers from each ethnic group, equal numbers of men and women within each ethnic group, and proportional representation of the main geographic areas of the island. In addition, subjects were recruited and stratified based on the 2000 Guam Census Data to assure proportional distribution by age. Dietary energy density (ED) was calculated as kcal/g and compared by gender, ethnicity, and obesity status. Mean BMI for Chamorros was significantly higher than for Filipinos, and a significantly higher proportion of Chamorros (49%) were obese compared to Filipinos (20%). Chamorros reported higher ED than Filipinos (1.9 kcal/g versus 1.6 kcal/g), although the difference was significant among males only. Non-obese subjects had a lower ED than obese subjects (1.9 versus 2.3 kcal/g). Overweight and obese subjects both reported a significantly higher % energy consumed as sugar-sweetened beverages than healthy weight subjects (8% and 9% versus 3%). Differences in ED may contribute to differences in obesity rates between Chamorros and Filipinos in Guam, particularly among men, and lowering ED may be an appropriate goal for nutrition interventions.

Key Words: Guam, energy density, obesity, Chamorro, Filipino

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关岛查莫洛人和菲律宾人的饮食和肥胖症

本研究的目的是比较居住在关岛年龄为25-65岁成年的查莫洛人(n= 66)和菲律宾人(n=61)的身体容积指数(BMI)和饮食摄入量。参加人员是通过社区采样被招聘的。但招聘却是以确保每一个民族有大约相同的数目,在同一民族中有同等数目的男性和女性,并在岛上能成比例地代表主要地区为目标的。此外,受试者的招聘和分配是基于2000年关岛人口统计数据并保证年龄成比例分布。饮食能量密度(ED)是按千卡/克计算并以性别,民族,和肥胖状态作比较。查莫洛人的平均身体容积指数显著高于菲律宾人,而且与菲律宾人 (20%)相比查莫洛人(49%)有显著高的肥胖症。查莫洛人报告ED高于菲律宾人(1.9 千卡/克 对1.6千卡/克),尽管显著的差异只表现在男性中。非肥胖受试者的ED低于肥胖受试者(1.9 千卡/克对2.3千卡/克)。超重和肥胖受试者都报告饮用蔗糖甜味饮料的能量%显著高于正常体重受试者(8% 和9% 对3%)。在关岛的查莫洛人和菲律宾人中间,特别在男性当中,ED的差异可以归因于肥胖的差异。降低ED可以作为营养干预的一个恰当的目标。 关键词:关岛,能量密度,肥胖症,查莫洛人,菲律宾人。

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Comparisons between anthropometric indices for predicting the metabolic syndrome in Japanese

MASAYUKI KATO, YOSHIHIKO TAKAHASHI, MANAMI INOUE, SHOICHIRO TSUGANE, TAKASHI KADOWAKI AND MITSUHIKO NODA, FOR JPHC STUDY GROUP

Aims: Most definitions of the metabolic syndrome (MS) employ waist circumference as an indicator of central obesity.  However, several reports, mainly from Asia, argue that other indices, for example the waist/height ratio, are superior to waist circumference for identifying subjects with cardiovascular risk factors.  We therefore investigated correlations between the predictive power of several anthropometric indices and risk factor accumulation (RFA) defined by the existence of two or more disorders among hypertension, dyslipidemia (high triglycerides and/or low levels of high density lipoprotein cholesterol) and fasting hyperglycemia; each of which is a component of MS.  Methods: We conducted a cross-sectional analysis using data from a part of the Japan Public Health Center-based Cohort.  A total of 315 men and 314 women, 51 to 70 years of age were examined for variables including waist and hip circumferences, blood pressure, fasting plasma glucose and lipids at an annual health check-up.  Results: The prevalence of RFA increased almost linearly in parallel with increasing waist circumference up to 95 cm.  Receiver operating characteristic analysis demonstrated that waist circumference was better than waist/ height ratio, waist/hip ratio and BMI at predicting RFA; but the differences were not statistically significant.  However, even in the case of waist circumference, no clear cut-off point yields sufficiently high sensitivity and specificity simultaneously.  Conclusions: The predictive power of waist circumference was not inferior to those of other indices.  Therefore, waist circumference is practically the most convenient measure for predicting MS because of its simplicity.

Key Words: metabolic syndrome, waist circumference, waist/hip ratio, waist/height ratio, body-mass index

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以日本人为对象的人体测量指标预测代谢综合症之比较

目的:代谢综合症(MS)的大多数定义,均以腰围作为中心性肥胖的测定指标。但也有某些主要来自亚洲的报告主张:在判别受试者是否具有心血管疾病危险因素时,使用腰∕身高比率这类指数优于采用腰围。由此,我们针对两种或更多些的症候,如高血压、血脂异常(高甘油三酯和∕或低水平高密度脂蛋白)与空腹高血糖;对部分人体指标预测力与危险因素积累(RFA)间的相关要素,做了一项调查。上述症候,无论何种皆为代谢综合症的病状之一。方法:根据由日本公众健康中心分组所得到的数据,我们进行了横断面分析调研。对于年龄在51至70岁之间的315名男性和314名女性,就其年度体检所获得的腰与臀围、血压、空腹血糖与脂状的数据,实施了变量检测。结果:腰围在95厘米以下時,危险因素积累的增加趋势几乎是与腰围的增加,呈线状平行。从受试者操作特性的分析中得以验证:与利用腰∕身高比率、腰∕臀比率及身体質量指数(BMI)来预测危险因素积累相比,腰围是一个更好的指标,但其间在统计学上无显著差异。然而,即使利用腰围进行测定,也还不能产生明晰的断开点能同时符合高灵敏度与高特异性。结论:利用腰围实施预测,其预测力並不亚于其他指数。因此,对于预测代谢综合症而言,事实上腰围是一种最方便的指数,因为该测试方法最为简单易行。 关键词:代谢综合症,腰围, 腰∕臀比率,腰∕身高比率,身体质量指数

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How useful is waist circumference for assessment of abdominal obesity in Korean pre-menopausal women during weight loss?

MI-JA HWANG, WON-SUK CHUNG, DYMPNA GALLAGHER, DEOG-YOON KIM, HYUN-DAE SHIN AND MI-YEON SONG

Asian women are known to have a larger amount of abdominal fat (AF) for the same level of BMI compared with Caucasian and African-American women. This study was aimed to determine whether waist circumference (WC) could be useful as an index of AF compared with AF measured by dual energy x-ray absorptiometry (DXA) before and after a weight-loss program in Asian women. Thirty-eight healthy, pre-menopausal obese Korean women (body fat percent > 30%) were enrolled and followed during a 6-week weight-loss program including herbal formula, calorie restriction, and exercise. Anthropometry and DXA measurements were performed before and after weight-loss. A specific region of interest (ROI, L2-iliac crest) by DXA was correlated with anthropometry at baseline: WC (γ = 0.91) > BMI (γ = 0.87) > Waist-Height ratio (WHtR, γ = 0.82) > WHR (γ = 0.46); and after weight loss: BMI (γ = 0.88) > WC (γ = 0.84) > WHtR (γ = 0.82), all p < 0.01. The change in DXA ROI showed a reasonable correlation with change in anthropometry: BMI (γ = 0 .63, p < 0.01) > WC (γ = 0.39, p < 0.05) > WHtR (γ = 0.37, p < 0.05). A stepwise multiple regression analysis revealed that 83% of the variance in DXA derived AF was explained by WC at baseline, WC and BMI at follow-up, respectively. This study suggests that WC could be a good predictor of AF for Korean pre-menopausal women.

Key Words: abdominal fat, Dual energy x-ray absorptiometry, obesity, waist circumference, fat distribution

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腰圍是否有效評估韓國停經前婦女在減重期間之腹部肥胖?

已知在相同的身體質量指數 (BMI) 下,亞洲婦女比起白種人以及非裔美國婦女有較多的腹部脂肪。本研究的目的是在減重計劃前後的亞洲婦女中,以雙能量X光吸收儀 (DXA) 測得的腹部脂肪做比較標準,測試腰圍是否為一個有用的腹部脂肪的指標。有38位健康、停經前的肥胖韓國婦女 (體脂肪比大於30%) 參與一個六星期的減重計劃,計劃中包括了草藥配方、限制熱量攝取及運動。在減重前後均執行體位及DXA的測量。在計劃開始時,由DXA檢測的一個特定區域 (L2-腸骨脊),與體位測量之間有相關:腰圍(r=0.91)>BMI (r=0.87)>腰圍身高比 (r=0.82)>腰臀比 (r=0.46);而減重後的相關性如下:BMI (r=0.88)>腰圍 (r=0.84)>腰圍身高比 (r=0.82)。DXA ROI的變化與體位測量的變化之間有適度的相關性:BMI (r=0.63, p<0.01)>腰圍 (r=0.39, p<0.05)>腰圍身高比 (r=0.37, p<0.05)。而逐步複迴歸分析顯示,在減重前藉由DXA測得的腹部脂肪,有83%的變異可以被腰圍所解釋,減重後則是可以被腰圍及BMI所解釋。本研究結果顯示對於停經前的韓國婦女,腰圍是腹部脂肪的一個好的預測因子。 關鍵詞: 腹部脂肪、雙能量X光吸收儀、肥胖、腰圍、體脂分佈

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Energy expenditure and energy intake in 10-12 years obese and non-obese Chinese children in a Guangzhou boarding school

CAI-XIA ZHANG, YU-MING CHEN, WEI-QING CHEN, XUE-QING DENG AND ZHUO-QIN JIANG

Objective: The objective of this study was to observe the variation of energy intake and energy expenditure in the obese Chinese children. Methods: Basic metabolic rate was measured by using open-circuit indirect calorimetry in 54 obese children and 60 non-obese children aged 10-12 years in a full- time boarding school in Guangzhou suburb, China. Total energy expenditure was estimated by using a factorial method. Dietary intake was surveyed by the weighed inventory method. Physical activity was determined using a 2-day activity diary. Results: Univariate analysis showed that basic metabolic rate was significantly higher (p<0.05) in obese children than in non-obese ones, but the significant difference disappeared after controlling for fat free mass and fat mass. Energy intake and total energy expenditure were significantly higher (p<0.05) in obese than in non-obese children. Obese children spent more time in sleeping and light physical activity, but less time in moderate physical activity and vigorous physical activity than non-obese children (p<0.05). Conclusions: Compared to non-obese children, both energy intake and expenditure were higher in obese Chinese children. It appears that an area for preventive strategies may be to encourage increased physical activity expenditure in this age group. Key Words: obesity, children, energy intake, energy expenditure, Chinese Guangzhou

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中國廣州市某寄宿學校10-12歲肥胖和非肥胖兒童能量消耗和能量攝入

目的:本研究的目的是觀察中國肥胖兒童能量攝入和能量消耗的變化。方法:以中國廣州市某寄宿學校10-12歲的54名肥胖兒童和60名非肥胖兒童爲研究對象。以開放式間接測熱法測定基礎代謝,總能量消耗採用因子加總法估算,盤存稱重法用于計量能量攝入,用2天的活動記錄來估計體力活動。結果:單變項分析顯示,肥胖兒童基礎代謝的能量消耗大於非肥胖兒童,統計上有顯著差異(p<0.05);但是控制了脂肪組織和瘦體組織後,基礎代謝的能量消耗在肥胖兒童和非肥胖兒童之間的差異沒有顯著性。肥胖兒童的能量攝入和總能量消耗高於非肥胖兒童 (p<0.05)。肥胖兒童花費的睡眠時間和輕體力活動時間多於非肥胖兒童,而中體力活動時間和重體力活動時間少於非肥胖兒童 (p<0.05)。結論:與非肥胖兒童相比,中國肥胖兒童的能量攝入和能量消耗較高。顯然對10-12歲的兒童,預防肥胖的策略之一可能是鼓勵增加體力活動的能量消耗。

關鍵字:肥胖,兒童,能量攝入,能量消耗,中國廣州

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Partial breastfeeding protects Bedouin infants from infection and morbidity: prospective cohort study

NATALYA BILENKO, ROHINI GHOSH, AMALIA LEVY, RICHARD J DECKELBAUM AND DRORA FRASER

The benefits of exclusive breastfeeding for health in infants have been widely described. The goal of this study was to determine whether partial breastfeeding has protective effects against enteric infection and associated morbidity in population where early addition of supplementation is common. In this prospective study 238 Bedouin infants were followed from birth to age 18 months. Exclusive breastfeeding was protective against infection and morbidity at ages 0 to 3 months. In the age range of 4 to 6 months, partial versus non breastfeeding was associated with lower rates of infection with Cryptosporidium spp (Odds Ratio OR 0.34, 95% confidence interval CI 0.18; 0.65), and Campylobacter spp (OR 0.58, CI 0.35; 0.98), lower rates of ear infections (OR 0.47, CI 0.24; 0.90) and of asthma (OR 0.33, CI 0.13; 0.81). In older children (10-12 month age range) partial breastfeeding as compared to none, protected against infections with Cryptosporidium spp (OR 0.57, CI 0.36; 0.91) and Giardia lamblia (OR 0.92, CI 0.85; 0.99). In Bedouins, and possibly in other populations, even partial breastfeeding, especially at ages 4 to 6 months offers protection against infection. Thus, encouraging mothers to continue to at least partially breastfeed past age 3 months may help reduce infections and morbidity in infants. Key Words: Bedouin, Breastfeeding, Enteric pathogens, Gastroenteritis, Primary health care

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部分的哺餵母乳可預防貝多因嬰兒的感染及罹病:前瞻性世代研究

完全哺餵母乳對嬰兒健康特有的好處已經被廣泛的敘述。這個研究的目的是去評估部分哺餵母乳在常見提早附加副食品的族群中,對於腸道感染及相關的罹病是否具有預防效果。在這個前瞻性研究中,238名貝多因族嬰兒從出生追蹤至18個月齡。完全哺餵母乳對0至3個月的嬰兒可降低感染及罹病率。在年齡範圍4至6個月,部份哺餵母乳比起未哺餵者,有較低的隱孢子蟲(Cryptosporidium spp) (OR 0.34, 95%CI 0.18; 0.65)與腸道弧菌(Campylobacter spp)(OR 0.58, CI 0.35; 0.98)感染率以及較低的耳朵感染(OR 0.47, CI 0.24; 0.90)與氣喘發生率(OR 0.33, CI 0.13; 0.81)。對較大的嬰兒(10-12月齡),部分哺餵母乳比起未哺餵的,可降低隱孢子蟲病(OR 0.57, CI 0.36; 0.91)及梨形鞭毛蟲(OR 0.92, CI 0.85; 0.99)感染。在貝多因人,及可能在其他族群,即使部分哺餵母乳,尤其是在年齡4至6月的嬰兒,可提供預防感染的效果。因此,鼓勵母親至少繼續部分哺餵母乳3個月以上,可以幫助減少嬰兒的感染及罹病率。

關鍵字:貝多因人、哺餵母乳、腸道病原菌、腸胃道、初級健康照護

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A comparative intervention trial on fish sauce fortified with NaFe-EDTA and FeSO4+citrate in iron deficiency anemic school children in Kampot, Cambodia

PHILIPPE LONGFILS, DIDIER MONCHY, HEIKE WEINHEIMER, VISITH CHAVASIT, YUKIKO NAKANISHI AND KLAUS SCHMANN

Background: Inhabitants of agrarian villages of rural Cambodia suffer from high prevalences of iron deficiency and anemia in the context of a monotonous diet. Objective: To compare the efficacy and safety of placebo Khmer fish sauce to that of 10 mL of fish sauce containing 10 mg of iron, added to daily school meals either as NaFe-EDTA or as FeSO4+ citrate. Methods: 140 students aged 6-21 years were enrolled in a double-blinded, placebo-controlled intervention trial. They were randomly allocated to one of three treatment groups, and followed for 21 weeks during which 114 school meals seasoned with 10 mL of fish sauce were consumed by each participant. Changes in the concentrations of hemoglobin (hb), serum ferritin (SF), and C-reactive protein (CRP) and in body weight and standing height were determined. Prevalences of vomiting, diarrhea, and acute respiratory infections were monitored weekly. Results: Both iron-fortified fish sauces increased hb and SF concentrations significantly as compared to placebo. No significant differences were observed between FeSO4+citrate and NaFe-EDTA fortification, regarding mitigation of iron-deficiency anemia (IDA) or regarding CRP, growth, infections, or side-effects. Conclusions: Iron-fortified Khmer fish sauce added to Khmer food is a suitable vehicle for iron fortification in children and adolescents. FeSO4+citrate and NaFe-EDTA show equivalent efficacy and safety. Key Words: NaFe-EDTA, FeSO4+citrate, iron fortification, fish sauce, efficacy, safety

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魚露以Na-Fe-EDTA或FeSO4+檸檬酸鹽強化在柬埔寨鐵缺乏貧血學童的比較介入性研究

背景:柬埔寨的鄉村,以農業為主的村落居民,在單調的飲食背景下,有高盛行率的鐵缺乏及貧血。目的:添加NaFe-EDTA或FeSO4+檸檬酸鹽於日常學校餐點中使用的魚露,以比較安慰劑魚露與每10 mL含10 mg鐵的魚露之功效與安全性。方法:Kampot省140名學生,年齡6-21歲,參與這個雙盲、安慰劑控制介入研究。他們被隨機分配至3介入組中的1組,追蹤21週,每名學生計攝取加入10 mL魚露調味的餐點114餐。隨後測量每名學生的血紅素(hb)、血清運鐵蛋白(SF)、C反應蛋白(CRP)及體重和站著的身高之改變。每週監測嘔吐、腹瀉及急性呼吸道感染的盛行率。結果:鐵強化魚露均顯示hb及SF濃度顯著地較安慰劑組高。以FeSO4+檸檬酸鹽或NaFe-EDTA強化,在減輕鐵缺乏貧血(IDA),或是CRP濃度、生長、感染率及副作用方面,兩者均無顯著差異。結論:鐵強化之魚露添加至柬埔寨人的飲食,對兒童及青少年的鐵強化是適合的媒介物。以FeSO4+檸檬酸鹽或NaFe-EDTA添加,顯示有相同的效力及安全性。

關鍵字:Na-Fe-EDTA、FeSO4+檸檬酸鹽、鐵強化、魚露、效力、安全性

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The effects of docosahexaenoic acid-rich fish oil on behavior, school attendance rate and malaria infection in school children – a double-blind, randomized, placebo-controlled trial in Lampung,Indonesia KEI HAMAZAKI, DIN SYAFRUDDIN, INSAN S TUNRU, MARINA F AZWIR, PUJI BS ASIH, SHIGEKI SAWAZAKI AND TOMOHITO HAMAZAKI

Background: There are only a very limited number of reports of intervention studies on the effects of fish oil on behavior in normal school children.  Objective: To observe the effects of fish oil on behavior and school attendance rates in school children. Design: Fourth to sixth graders (mostly 9-12 years of age) of an elementary school in Lampung Province, Indonesia, were randomly divided into either a docosahexaenoic acid (DHA) group (n=116) or a control group (n=117) in a double-blind manner. The subjects in the DHA group took 6 fish oil capsules per day (0.65g DHA and 0.10g eicosapentaenoic acid (EPA)/day) for 3 months. Controls took soybean oil capsules. Two questionnaires were administered and blood was taken at the start and end of the study. Two questionnaires were administered at the start and end of the study: Hostility-Aggression Questionnaire for Children (HAQ-C) and Barratt Impulsiveness Scale, version 11 (BIS-11), for measurement of aggression and impulsivity, respectively. Attendance was recorded during the study period.  Outcomes: The concentrations of DHA and EPA in the phospholipid fraction in red blood cells were significantly increased in the DHA group. Behavior checked with HAQ-C or BIS-11 did not show any differences between groups. However, the odds ratio of inability to attend school regularly during the study period was 0.40 (95%CI: 0.23-0.71) in the DHA group compared with controls (p=0.002).  Conclusions: DHA-rich fish oil may improve the school attendance rate of children in Lampung, Indonesia Key Words: behavior, fatty acid composition of red blood cells, fish oil, intervention study, malaria, school attendance rate

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富含二十二碳六烯酸魚油對行為、學校出席率及瘧疾感染的效應:印尼Lampung雙盲隨機安慰劑控制試驗

背景:對一般的學童,只有非常少數的介入性實驗報告說明魚油對學童行為的影響。目的:觀察魚油對於學童的行為及學校出席率的影響。設計:研究對象來自於印尼楠榜省(Lampung Province)的一間小學四到六年級學童(大部分年齡在9-12歲),以雙盲的方式將研究對象隨機分派到DHA組(n=116)或控制組(n=117)。在DHA組中的研究對象,每天服用6顆魚油膠囊(每日0.65 g DHA和0.10 g EPA),持續三個月。控制組則是給予大豆油膠囊。在實驗開始及結束時有抽血及填答兩份問卷:HAQ-C以及BIS-11,分別用來評量學童的敵意性-攻擊性及衝動行為。在實驗期間,也記錄學童的到校出席情形。結果:紅血球磷脂質中的DHA及EPA濃度,在DHA組中有顯著的增加。使用HAQ-C以及BIS-11所檢測的行為,在兩組中並沒有任何差異。然而,與控制組比較,DHA組學童,實驗期間無法定期上學的可能比率(OR)為0.40(95%CI: 0.23-0.71, p=0.002)。結論:富含DHA的魚油或許可改善印尼楠榜省學童的學校出席率。

關鍵字:行為、紅血球脂肪酸組成、魚油、介入研究、瘧疾、學校出席率

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Effect of iron fortification of nursery complementary food on iron status of infants in the DPRKorea HUIYONG RIM, SUHUAN KIM, BYONGCHEL SIM, HAEYONG GANG, HOYONG KIM, YONGRAN KIM, RAKCHEL KIM, MUNHUI YANG AND SANGPIL KIM

The aim of this study was to determine the iron status of infants who consumed porridge cooked in water with added ferrous sulphate. A total of 234 infants, aged 6~12 months, were recruited from 36 nurseries in the Democratic Peoples Republic of Korea (DPRK  North Korea) and randomly divided into iron (Fe) and placebo groups. At baseline, almost half the children had Hb<110 g/L and no significant differences between the two groups were found with regard to hemoglobin concentration and anemia prevalence. The Fe group received rice porridge fortified with 10 mg of iron (as ferrous sulfate) per day, added to the water in which the rice was cooked and the placebo group non-fortified cereal for 6 months. After which, the hemoglobin (Hb), serum ferritin (SF) and packed cell volume (PCV) were measured and it was found that the proportion of children with anemia (Hb<110 g/L) was lower  (24.3% v 48.1% p< 0.01), the  Hb levels (117.6 g/L v 109.8 g/L p<0.001) and serum ferritin were higher (40.7 v 26.8 mcg/L p<0.001); and  iron  deficiency anemia (Hb<110 g/L, SF<12 mcg/L) was lower in the Fe group (3% v 22% p<0.001) when compared to the placebo group. Ferrous sulphate, added to the water in which rice was cooked, lowered the prevalence of iron deficiency anemia of infants in the DPRK with no adverse reactions.  This simple fortification would be suitable as a nationwide program in the DPRK and other countries with large infant nurseries. Key Words: iron status, iron deficiency anemia (IDA), iron fortification, infant, nursery food

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添加鐵副食品對北韓嬰兒鐵狀況之效應

本研究想了解在煮粥水中添加硫酸亞鐵,而讓嬰兒攝取米粥後,其體內鐵的狀況。自北韓36個育嬰所徵招年紀6-12個月大的嬰兒234位,隨機分配為鐵攝取組和安慰劑組。一開始,幾乎一半的嬰兒血紅素少於110 g/L,而且兩組在基礎血紅素濃度和貧血盛行率上都沒有差異。鐵攝取組每天攝取含10毫克鐵的米粥,是將硫酸亞鐵加入水中,再用此水烹煮米粥,而安慰劑組則是攝取沒有強化過的粥。試驗期6個月後,測量血紅素、血清鐵蛋白和紅血球比容積。結果發現鐵攝取組比安慰劑組嬰兒貧血的比例較低,血紅素和血清鐵蛋白濃度較高,缺鐵性貧血率較低。硫酸亞鐵加入水中和米粥一起烹煮,能使北韓缺鐵性貧血嬰兒的盛行率降低且無有害副作用。這樣簡單的強化方法或許適用於北韓的全國性計劃和有大型育嬰所的其它國家。

關鍵字:鐵狀況、缺鐵性貧血、添加鐵、嬰兒、育嬰所食品

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Nutrient intake risk factors of osteoporosis in postmenopausal women JEONGSEON KIM, SUN-YOUNG LIM AND JOO-HAK KIM

This study was conducted to assess the association between dietary nutrient intake and osteoporosis risk in postmenopausal women. Bone mineral density was measured at the lumbar spine by dual-energy X-ray absorptiometry and a structured questionnaire was administered by a trained interviewer, which included information on sociodemographics, medical and reproductive history, and dietary intake. The study sample included 134 osteoporotic and 137 non-osteoporotic subjects between the ages of 52 and 68. Nutrient variables were classified into tertiles. Odds ratios and 95% confidence intervals (CI) were calculated which compared the highest tertile with the lowest tertile as a reference group. Odds ratios for osteoporosis were 1.47 (95% CI: 1.03 – 2.05) for total protein, 1.62 (95% CI: 0.51 – 3.92) for animal protein, and 2.98 (95% CI: 1.42 – 4.23) for sodium.  Odds ratios for osteoporosis in the highest tertile were: 0.42 (95% CI: 0.23 – 0.83) for vegetable protein, 0.72 (95% CI: 0.51 – 0.90) for Ca, and 0.65 (95% CI: 0.49 – 0.88) for Fe, relative to the respective lowest tertile. These findings suggest that adequate nutrient intake may be important for prevention of osteoporosis in postmenopausal women. Key Words: nutrient, diet, osteoporosis, menopause, risk

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影響更年期女性骨質疏鬆的營養攝取危險因子

本研究評估停經後期女性飲食中營養素攝取與骨質疏鬆危險性之關係。骨質密度測量方式,在腰椎部位利用雙能量X光吸收儀測量獲得。問卷部分,請受過訓練的訪視者以有架構的問卷進行訪談,其中包含的資訊為:社會人口學變項、用藥及生育史、飲食攝取。研究樣本收集134位骨質疏鬆與137位沒有骨質疏鬆之受試者,年齡為52歲至68歲之間。各營養素攝取量劃分為四分位。以最低攝取量組當作參考組,將最高組與最低組相比較,計算出勝算比(odds ratio)及信賴區間。對骨質疏鬆的發生,總蛋白質攝取量之勝算比為1.47,動物性蛋白質為1.62,鈉為2.98。反之,植物性蛋白質之勝算比為0.42,鈣為0.72,鐵為0.68。本研究的發現指出在停經後女性中,適當的營養素攝取可能對於預防骨質疏鬆是重要的。

關鍵字:營養素、飲食、骨質疏鬆、停經、危險因子

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Serum zinc levels amongst pregnant women in a rural block of Haryana State, India PRIYALI PATHAK, UMESH KAPIL, SADA NAND DWIVEDI AND RAJVIR SINGH

Introduction: Zinc deficiency is wide spread in developing countries. Its deficiency during pregnancy has been documented to be associated with growth retardation, congenital abnormalities, and low birth weight. Limited community based data is available on the serum zinc levels during pregnancy from Haryana State, India. Hence the present study was undertaken. Methods: A community based cross sectional study was conducted amongst 283 pregnant women with gestational age of 28 weeks or more. Each pregnant woman was inquired about her age, obstetric profile, socio-economic status, and other demographic parameters by utilizing a pre-tested semi-structured questionnaire. Blood from the antecubital vein was drawn to assess the serum zinc levels utilizing the atomic absorption spectrophotometer. Nutrient intake was assessed by the standard 24-hr dietary recall method. Statistical tests were applied to the data collected. Results: Mean serum zinc level was 61.1 16.6 g/dL. Almost 64.6% of the women had zinc deficiency. The dietary data revealed that 58.9 % of the women were consuming calories less that 75% of the recommended, indicating an overall poor food intake. Dietary zinc intake revealed that 86.2 % of the women were consuming less than 50% of the recommended (15 mg). A high prevalence of zinc deficiency (64.6%) was found amongst the pregnant women possibly due to the low dietary intake of zinc. There is a need to undertake multi-centric studies in various parts of the country to assess the serum zinc levels, magnitude of zinc deficiency and factors leading to zinc deficiency amongst pregnant women in India. Key Words: Serum zinc levels, zinc deficiency, pregnant women, pregnancy, rural India

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印度Haryana州的鄉下地區懷孕婦女血清鋅含量

前言:在發展中國家,鋅缺乏普遍存在。有文獻指出,懷孕時期的鋅缺乏與胎兒生長遲滯、先天畸形及低出生體重有相關。在印度Haryana州,懷孕婦女血清鋅的基礎資料很有限,因此著手進行這個研究。方法:一個以社區為基礎的橫斷性研究,有283名妊娠週數在28週或以上的懷孕婦女參與。利用前測的半結構式問卷,詢問每名孕婦有關於他們的年齡、生產資料、社經狀況及其他的人口學參數。抽取前臂尺骨靜脈的血液,利用原子吸收光譜評估血清鋅含量。以標準24小時飲食回憶法評估營養素攝取量。用統計檢測收集的資料。結果:平均血清鋅濃度為61.1 16.6 g/dL,幾乎64.6%的婦女有鋅缺乏。飲食資料顯示58.9%的婦女熱量攝取低於建議量的75%,表示整體飲食攝取都差。有86.2%的婦女膳食鋅攝取少於建議量(15 mg)的一半。研究發現在這些孕婦中64.6%有鋅缺乏,這可能歸因於不足的膳食鋅攝取。需要在國內的不同地區的多個中心進行研究,以評估印度的孕婦血清鋅含量,釐清鋅缺乏的嚴重性及導致鋅缺乏的因子。

關鍵字:血清鋅量、鋅缺乏、孕婦、懷孕、印度鄉下。

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Dietary supplementation by older adults in Japan FUMI HIRAYAMA, ANDY H LEE, COLIN W BINNS, FUMIKO WATANABE AND TOMOYA OGAWA

This study documented the prevalence and pattern of dietary supplements usage among older adults in Japan. Persons aged 55-75 years residing in middle and southern Japan were recruited and interviewed face-to-face on their use of dietary supplements. Among the 572 (355 male and 217 female) participants from 10 prefectures, 45.8% took supplements on a weekly or daily basis, the prevalence was higher for women (52.5%) than men (41.7%). Many types of miscellaneous supplements were consumed. The most popular supplement was vinegar for both men (11.0%) and women (15.2%), followed by energy drink (8.5%) for men, and multivitamin (8.5%) for men and vitamin C (8.3%) for women. The findings suggested an increasing trend of dietary supplementation by Japanese older adults when compared to previous studies. Key Words: dietary supplement, older adults, prevalence, Japan

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日本中老年人膳食補充劑使用狀況

本研究記敘在日本的中老年人,使用膳食補充劑的盛行率及其型式。研究對象是徵募居住在日本中南部,年齡在55-75歲之間的長者,以面對面的訪談來了解他們使用膳食補充劑的情形。來自於日本10個縣的572位(355位男性和217位女性)研究對象中,有45.8%的人每週或每天服用膳食補充劑;其中,女性使用膳食補充劑的盛行(52.5%)高於男性(41.7%)。有各式各樣的補充劑被食用,在男性及女性中最普遍的補充劑是醋(男性11.0%、女性15.2%),在男性其次為能量飲料(8.5%)以及綜合維他命(8.5%),在女性則是維生素C(8.3%)。與過去的研究做比較,本研究發現,日本中老年人膳食補充劑的使用有增加的趨勢。

關鍵字:膳食補充劑、中老年人、盛行率、日本

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Prevalence of malnutrition in free living elderly people in Iran: a cross-sectional study MALIHEH ALIABADI, MASOOD KIMIAGAR, MAJID GHAYOUR-MOBARHAN, MOHAMMAD TAGHI SHAKER, MOHSEN NEMATY, ALI AKBAR ILATY, AJMAD-REZA MOOSAVI AND SUE LANHAM-NEW

Introduction: The elderly are a particularly vulnerable group. Malnutrition is common and increases an old person’s vulnerability to disease. We determine the prevalence of malnutrition in free living elderly people and its relationship with nutritional status and some ocioeconomic conditions. Methods: Nutritional status and its relationship with socioeconomic conditions were evaluated using Mini Nutritional Assessment in free-living elderly people (n=1962 using cluster sampling, 917 male/1045 female, aged>60). Results: Among the population, 42.7% were well nourished, 12.0% malnourished and 45.3% at risk of malnutrition. There was more  malnutrition in females compared to males (13% vs. 10.8%; p<0.001), rural than urban (14.8% vs. 9.9%; p<0.001), non educated than educated (13.3% vs 6.9%; p<0.001), lonely than living with family (17.5% vs. 10.3%; p<0.001), unemployed than employed (13.3% vs. 6.3%; p<0.05), elderly on income support (Behsisty charity) compared with elderly on retirement salary, (41.7% vs. 3.3%; p<0.05). Total Mini Nutritional Assessment scores correlated significantly with length of education, age, waist circumference, and body mass index (r =0.426, -0.142, 0.355 and 0.269 respectively). Conclusion: This study revealed a 12% malnutrition prevalence in this elderly group, with higher percentages in special socioeconomic conditions. Health care providers need to be aware of this problem and its scope. These results reinforce the need to screen, monitor and support elderly people. Key Words: Free living elderly people, nutritional status, socioeconomic conditions (SEC), Body mass index (BMI)

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伊朗居家老人之營養不良盛行率:一橫斷面研究

老年人是一個較脆弱的族群。營養不良普遍存在於老年人中,並且會增加老年人罹病的風險。我們評估在家居住老人的營養不良盛行率及營養狀態與社經狀況的關係。方法:利用迷你營養評估表(MNA)來評估在家居住老人(利用群集抽樣,抽取1962位研究對象,包含917位男性及1045位女性,年齡大於60歲)的營養狀態及其與社經狀況的相關性。結果:在研究對象中,有42.7%的人有良好的營養狀況、12%營養不良、以及45.3%有營養不良的風險。而營養不良的比例:女性比男性高(13% vs. 10.8%; p<0.001)、鄉村地區高於城鎮地區(14.8% vs. 9.9%; p<0.001)、沒有受教育高於有受教育者(13.3% vs 6.9%; p<0.001)、獨居高於與家人同住(17.5% vs. 10.3%; p<0.001)、失業高於有工作者(13.3% vs. 6.3%; p<0.05)、領取收入津貼(Behsisty charity)的高於有退休金的老年人(41.7% vs. 3.3%; p<0.05)。此外,總迷你營養評估分數與受教育的年限、年齡、腰圍、以及BMI之間有顯著的相關性(相關係數分別為0.426、-0.142、0.355、以及0.269)。結論:本研究發現,在這一個老年族群中有12%的營養不良盛行率,並且某些特殊社經狀況的老年人佔有較高的百分比。健康照護的提供者需要了解這個問題及其範疇。這些結果加強了需要篩選、監測、及支持老年人的重要性。

關鍵字:伊朗、居家老人、營養狀態、社經狀況、身體質量指數

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The relevance of the Heart Foundation of Australia’s dietary recommendations for adult Australians: a comparison of views of general practitioners, cardiologists and dietitians SYLVIA POMEROY AND A WORSLEY

Purpose: To compare the views of general practitioners, cardiologists and dietitians about the relevance of the Heart Foundation of Australia’s dietary recommendations for adult cardiac patients. Basic procedures: Quantitative-cross sectional study. Postal questionnaires were self-completed by 248 Victorian general practitioners (30% response), 189 Australia-wide cardiologists (47% response) and 180 Victorian dietitians (45% response). Responses were represented as percentages and analyses of variance were conducted to explore the impact of the independent variables: age, work status and gender on the dependent variable: dietary recommendation. Main findings: Approximately half of the recommendations were viewed as strongly important to implement; these related to lean meats, limiting takeaways and cakes/biscuits, and adjusting energy intake. Others of importance were eating fruits, vegetables and fish. However, most of these goals were seen as difficult to achieve. Dietitians appeared to share responses of doctors, except for greater importance of eating fruit and vegetables and a greater difficulty in limiting cakes and biscuits. There was a high level of agreement among the three groups (mean 87%) about patients having difficulty implementing adjusting energy intake. Conclusions: There is agreement amongst these professionals that many of the recommendations lack importance, specifically those pertaining to unsaturated oils, low fat dairy products, cholesterol rich foods, intake of legumes and grains and the restriction of salt. This may reflect a need for further nutrition education. Key Words: General practitioners, Cardiologists, Dietitians, Food based dietary recommendations, Food selection recommendations

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攸關澳大利亞心臟基金會對成年人之飲食建議:比較醫師、心臟科專家和營養師的觀點

目的:比較醫師、心臟科專家和營養師針對澳大利亞心臟基金會制訂的成年心臟患者飲食建議的看法。方法:定量的橫斷性研究。郵寄問卷為自填式回答,分別給248位維多利亞省的醫師(回應率30%)、189位全澳的心臟科專家(回應率47%)和180位維多利亞省的營養師(回應率45%)填寫。回應率以百分比表示,回收問卷以變異分析自變項的影響,分別為年齡、工作狀況和性別,依變項為飲食建議。結果:大約有一半的飲食建議項目被強烈認為重要且需要去實行:分別是關於攝取瘦肉、限制速食及蛋糕/餅乾和調整熱量攝取,另外,攝取蔬菜、水果和魚也是很重要的。但是大部分的建議目標看似難以達成。營養師的看法與醫師大體上相似,除了營養師特別強調水果和蔬菜攝取的重要性且認為限制甜點/餅乾是較困難的。對於調整熱量攝取的困難度,三組之間有相當高的ㄧ致看法(平均87%)。結論:不少專業人員都認為有些飲食建議的重要性不大,特別是關於不飽和脂肪、低脂乳製品、富含膽固醇的食物、豆類和穀類攝取及限鈉方面。這些反映出執行繼續營養教育的需求性。

關鍵字:執業醫師、心臟科專家、營養師、飲食指標、食物選擇建議

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Assessing physical activity in an Asian country: Low energy expenditure and exercise frequency among adults in Taiwan JACKSON PUI MAN WAI, CHI PANG WEN, HUI TING CHAN, PO HUANG CHIANG, MIN KUANG TSAI, SHAN POU TSAI AND HSING-YI CHANG

Leisure-time physical activity (LTPA) has been closely related to health improvement. The under-appreciation for energy output by nutritionists stems in part from limited data expressed in caloric equivalent. We converted the frequency, duration, and intensity of LTPA, reported from 15,390 adults in the Taiwan National Health Interview Survey 2001, into kilocalories (kcal). Half of Taiwanese adults admit to no LTPA. Women, lower education or income, younger age, smokers and chewers of betel quid; exercised significantly less than their counterparts. Less than 1/5 (18.9%) of the population in Taiwan was physically active at 750 kcal/week, and only 1/7 (13.9%) reached a more desirable goal of 1,000 kcal/week, compared with 1/3 in the U.S. The most disconcerting finding was the Taiwan unique U-shaped prevalence for males, with the 25-44 age group being the least active, 65 age group being the most active; and S-shaped for females, lowest at age 18-24 years and highest at the two older groups (45-64 and 65 years). LTPA was under-appreciated, particularly among the most productive work force (25-44-year group), who exercised with a prevalence only 1/4 of their U.S. counterparts. Expressing LTPA in kcal makes direct comparison easier. Invoking a goal of 750 kcal/week for Asians, attainable by exercising 4 hours/week, can facilitate nutritionists in assessing LTPA adequacy. Currently, 4/5 of adults in Taiwan failed to reach this goal. Recognizing the concept of cumulative energy expenditure, in contrast to disciplined daily work for 5 or more days, will encourage the infrequent exercisers such as “weekend warriors” to continue with their activities. Key Words: Exercise, Kilocalorie, Leisure-time physical activity, Prevalence

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臺灣民眾運動習慣及盛行率之分析

背景:運動對健康的好處毋庸置疑,在亞洲以實證數據及國際定義為依據之全民運動盛行率報告仍付之闕如。目的:瞭解臺灣民眾運動的盛行率及其相關因素,並轉換成以卡路里 (kcal) 為指標。方法:對象為2001年國民健康訪問調查共15,390位成人,根據對運動問題之答案,估計其運動強度的MET值 (metabolic equivalent),依運動頻率、時間及強度換算成kcal而加以分析。結果:半數以上的成人自認完全不運動。女性、低教育程度、低收入、較年輕族群及吸菸、嚼檳榔者,其運動習慣及運動量明顯較少。依是否達到每週750 kcal之運動熱量來評估,臺灣成人有運動的盛行率不到總人口的1/5 (18.9%)。達到較理想的每週1000 kcal的運動量,只有總人口的1/7 (13.9%),是美國有運動的盛行率三分之一。男性各年齡層的運動盛行率以青壯年 (25-44歲者) 有運動的最少,老年(65歲以上)有運動的最多,呈現臺灣特有的U型曲線;女性各年齡層運動盛行率,運動最少的族群是在18-24歲及25-44歲,45歲之後才昇高,呈現S型曲線。運動在臺灣普遍不受到重視,特別是在25-44歲的族群,其盛行率只有美國的1/4。結論:目前臺灣民眾運動習慣偏低且運動量嚴重不足,達到每週消耗750 kcal低竿的運動人口不到全體的1/5。本研究並提出「每週運動若能消耗 750 kcal,亦即運動時間要能每週累積4小時」之新目標,以方便宣導運動的新指標,這個“累積”的概念,和以往硬性規定每週至少5天以上的宣導不同,可以鼔勵非規律運動者,如集中在週末運動的所謂-“週末勇士”達到促進健康運動量的目標。

關鍵字:運動、卡路里、休閒運動、盛行率

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A participatory assessment of dietary patterns and food behavior in Pohnpei, Federated States of Micronesia ALLISON CORSI, LOIS ENGLBERGER, RAFAEL FLORES, ADELINO LORENS AND MAUREEN H FITZGERALD

Non-communicable diseases are escalating rapidly within the Pacific region, including Pohnpei, Federated States of Micronesia. A shift in dietary patterns from indigenous, high fiber, healthy local food to energy-dense, imported food with low nutritional value, and increased sedentary lifestyles are expediting this process. Essential to counteract this trend is an understanding of how people make food decisions. This participatory assessment utilized a quantitative and qualitative approach to capture diet patterns and knowledge, attitudes, beliefs and practices of food consumption. A structured 7–day food frequency questionnaire (FFQ) was used to quantify the diets of 293 adult Pohnpeian women attending an island-wide education/disability screening program. An ethnographic approach, including in-depth interviews, informal focus groups and observations documented food behavior practices and contributed to the design of the FFQ. Of those responding to the FFQ, 96% reported eating rice frequently (3-7 days/week) whereas 75% reported eating locally grown carbohydrate foods frequently. Factors associated with culture change, including availability, affordability, convenience, and status of food items were found to determine food decisions. Food-based, culturally sensitive and innovative strategies that utilize existing resources are required to promote local food production and consumption. Prevention programs with an information, education and communication (IEC) approach are needed to provide accurate and available health and nutrition knowledge and to increase the demand for local foods. Behavior modification requires the continued collaboration of the national, state, and community organizations that partnered on this research to strategize programs in order to target individual food choices and to transform the environment to support these decisions. Key Words: Micronesia, dietary patterns, type 2 diabetes, obesity, nutrition transition

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參與性評估密克羅尼西亞聯邦波納佩州的飲食模式與食物行為

在太平洋地區,非傳染性疾病快速地增加,密克羅尼西亞聯邦波納佩州(Pohnpei)也是如此。飲食模式從固有的、高纖維、健康當地食材轉成高熱量密度、低營養價值的進口食物以及增加久坐的生活型態都加速這個進程。對抗這個趨勢必須先了解人們如何決擇食物。參與性評估是利用一個量化及定性的方法去獲知飲食模式及飲食攝取的認知、態度、信念與實行。使用7天的結構性飲食頻率問卷(FFQ)去量化293名參加全島嶼的教育/失能篩檢系統的波納佩州成人女性。以一個人種誌的方法,包含深入的訪問、非正式的焦點團體及觀察來記錄食物行為的實行及貢獻FFQ的設計。回覆FFQ的女性中,有96%報告經常吃米飯(3-7天/週),反之75%報告經常吃當地生長的碳水化合物食物。與文化改變的相關因子,包含可獲性、支付能力、便利性及食物項目的狀態會決定食物的選擇。必須以食物為基礎,對文化有認知及利用現有資源的創新政策去促進當地食物的產量及攝取。需要包括資訊、教育及交流(IEC)的預防性計劃以提供正確及可得的健康及營養知識,並且去增加對當地食物的需求。行為的修飾需要國家、州及社區組織的繼續合作,以便針對個人的食物選擇及支持這些選擇的環境轉換訂出策略。

關鍵字:密克羅尼西亞、飲食模式、第二型糖尿病、肥胖、營養轉換。

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The extent and nature of “health messages” in magazine food advertising in Australia SANDRA C. JONES, KELLY L ANDREW, LINDA TAPSELL, PETER WILLIAMS AND DANIELLE MCVIE

Objective: To quantify the extent and nature of healthy eating messages Australian consumers are currently exposed to through magazine advertising. Method: Analysis of healthy eating messages in advertisements found in the top 30 Australian magazines between January and June 2005 was conducted. Advertisements were analysed and classified by source, subject, food category, food type, food occasion, type of claim and disease type. Results: A total of 1,040 advertisements were identified which contained a healthy eating message; after removing duplicates, 390 advertisements were analysed. Culinary and women’s magazines contained the greatest number of healthy eating messages.  The most frequently occurring food category utilising a health message in an advertisement was dairy and dairy substitutes (71/390), closely followed by fruit and fruit juice (70/390). Overall, 31 advertisements referred to a specific disease, health problem, or risk factor and the most commonly mentioned were heart disease/heart-attack (12) cancer (seven) and diabetes (five). Conclusions: Majority of healthy eating messages currently advertised are by manufacturers, double that of retailers, with non-commercial sources representing only 2%.  Processed foods were the most commonly advertised food form which contained a healthy eating message, this is of concern given the generally low nutritional value of these foods.  Overall, there are a large number of advertisements in Australian magazines that contain healthy eating messages that may have the potential to communicate to consumers that there are health benefits associated with the consumption of certain foods. Implications: Future research to assess the accuracy of the information in such advertisements, and to examine consumer interpretations of these health message are important. Key Words: health claims, health messages, food standards, advertising, magazines

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澳大利亞雜誌食品廣告的健康訊息的程度和特性

目的:針對澳大利亞雜誌廣告帶給消費者的健康飲食訊息的程度和特性做量化的探討。方法:檢視2005年1 -6月間的前30名雜誌刊載的廣告中透露的健康飲食訊息。對這些廣告做分析且依據來源、主題、食物類別、食物型態、食物場合、聲稱種類和疾病種類加以分類。結果:總數1040個廣告被認為有健康飲食的訊息,但在排除相同內容之後,剩下390個廣告進行研究分析。在烹飪和女性雜誌方面出現最多數的健康飲食訊息。食物類別方面以乳製品及乳品替代品的廣告最常使用健康飲食訊息(71/390),緊接著為水果和果汁(70/390)。整體而言,有31個廣告內容是針對特定疾病、健康問題或危險因子,且最常被提及的是心臟病/心血管疾病(12)、癌症(7)和糖尿病(5)。結論:現今大多數的雜誌廣告健康飲食訊息是由製造廠商來做宣傳,是零售業的兩倍,而非廣告來源的僅佔2%。食物型態方面以加工食品的廣告最常含有健康飲食訊息,這是值得關注的,因為它們一般是營養價值較低的食物。總結來說,澳大利亞雜誌廣告中的健康飲食訊息,可能有力地傳播給消費者關於吃某種食物有益健康的聯想。啟示:迫切需要未來研究去評估這些廣告訊息的正確性和檢測消費者如何判讀這些健康飲食訊息。

關鍵字:健康聲稱、健康訊息、食物標準、廣告、雜誌

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Association between C677T/MTHFR genotype and Homocysteine Concentration in a Kazakh Population AINUR AKILZHANOVA, NOBORU TAKAMURA, YOSUKE KUSANO, LUDMILA KARAZHANOVA, SHUNICHI YAMASHITA, HIROSHI SAITO AND KIYOSHI AOYAGI

We recently suggested that due to insufficient intake of vegetables, low folate status and mild homocysteinemia might exist in the Kazakh population. To clarify the determinants of homocysteine concentrations among this population, we determined concentrations of serum folate, albumin, creatinine, vitamin B12, and the C677T/ MTHFR genotype in 110 Kazakh individuals and compared these with plasma total homocysteine. In Kazakh, after adjustment for age and sex, folate was correlated with plasma total homocysteine, whereas concentrations in those with the TT genotype was almost twice as high as in those with the CC and CT genotypes (19.71.8 mol/L vs. 10.70.5 mol/L, p<0.001). Our results suggest that the C677T/MTHFR genotype is associated with homocysteine concentrations in this population and this association might be affected by other factors, such as folate status. Key Words: folate, homocysteine, Kazakh, 5,10-methylenetetrahydrofolate reductase

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一個哈薩克族群之C677T/MTHFR基因型與同半胱胺酸濃度的關係

近來,我們認為由於蔬菜攝取不足,在哈薩克人中可能有低葉酸以及輕微的同半胱胺酸血症的問題存在。為釐清哈薩克族群中同半胱胺酸濃度的決定因素,我們測定110位哈薩克人的血清葉酸、白蛋白、肌酸酐、維生素B12的濃度及C677T/MTHFR基因型,並且與血漿中總同半胱胺酸濃度作比較。在哈薩克,校正了年齡及性別之後,葉酸與血漿總同半胱胺酸有關,TT基因型者其濃度幾乎是CC以及CT基因型的兩倍高(19.71.8 mol/L vs. 10.70.5 mol/L, p<0.001)。我們的結果顯示,在這個族群中C677T/MTHFR基因型與同半胱胺酸濃度之間是有關聯性的,而這個關聯性可能藉由其他因子,例如葉酸狀態,而被影響。

關鍵字:葉酸、同半胱胺酸、哈薩克、5,10 –次甲基四氫葉酸還原酶

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High plasma homocysteine is associated with the risk of coronary artery disease independent of methylenetetrahydrofolate reductase 677CT genotypes PING-TING LIN, MEN-CHUNG HUANG, BOR-JEN LEE, CHIEN-HSIUNG CHENG, TSUNG-PO TSAI AND YI-CHIA HUANG

Hyperhomocysteinemia is an independent risk factor for coronary artery disease (CAD). The aim of this study was to investigate the relations between the methylenetetrafolate reductase (MTHFR) 677C T genotypes, B-vitamins (folate, vitamin B-12 and B-6), homocysteine and the risk of CAD. In this case-control study, patients who were identified by cardiac catheterization as having at least 50% stenosis of one major coronary artery were assigned to the case group (n = 121). Healthy individuals with normal blood biochemical values were assigned to the control group (n = 155). Healthy subjects were matched to case subjects for age. The concentrations of plasma homocysteine, serum folate, vitamin B-12, plasma pyridoxal 5’- phosphate (PLP) and MTHFR 677C→T gene polymorphism were obtained. The T-allele carriers had significantly higher plasma homocysteine concentration compared to subjects with the 677CC genotype. The MTHFR 677CT genotypes were associated with plasma homocysteine after adjusting for various potential risk factors in the case and pooled groups. The MTHFR genotypes were found to have no associations with the risk of CAD. However, plasma homocysteine ( 12.5 mmol/L) (OR, 3.49; 95% CI, 1.23 – 9.88) had a significant association with increased risk of CAD even after additionally adjusted folate status. High plasma homocysteine concentration had a direct effect on the risk of CAD independent of MTHFR 677CT genotypes. Key Words: methylenetetrahydrofolate reductase, gene polymorphism, homocysteine, B-vitamins, coronary artery disease

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同半胱胺酸而非甲基四氫葉酸還原酶(MTHFR 677CT)基因多型性顯著獨立增加罹患冠狀動脈心臟病之危險性

高同半胱胺酸血症已被認為是冠狀動脈心臟病獨立危險因子之一。本研究為病例-對照組之研究,其目的為探討血漿同半胱胺酸(Hcy)及甲基四氫葉酸還原酶(MTHFR 677CT)基因多型性與罹患冠狀動脈心臟病(CAD)之相關性。病例組由台中榮總心臟內科門診募集CAD受試者,並經心導管檢查發現冠狀動脈狹窄程度 50%者(n = 121);對照組受試者則於台中榮總健檢中心募集,經檢查有正常血清生化值者,且年齡與CAD受試者配對(n = 155)。結果發現攜帶677TT基因型之受試者,其血漿Hcy濃度顯著高於677CC者;而MTHFR 677CT基因之多型性與CAD危險對比值卻無顯著相關性。邏輯式回歸顯示當血漿同半胱胺酸濃度大於12.5 mmol/L時,會顯著增加罹患CAD之危險對比值,即使調整血清葉酸後,此顯著性仍然存在(OR,3.49;95% CI, 1.23 – 9.88)。因此本研究認為高同半胱胺酸直接且顯著影響罹患CAD危險性。

關鍵字:五甲基四氫葉酸還原酶、基因多型性、同半胱胺酸、B-維生素、 冠狀動脈心臟病。

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Body mass index (BMI) as a major factor in the incidence of the metabolic syndrome and its constituents in unaffected Taiwanese from 1998 to 2002 FENG-YU YANG, MARK L WAHLQVIST AND MEEI-SHYUAN LEE

A large health screening program in Taiwan with members who have periodic checks provides an opportunity to track individuals who are healthy at baseline for the emergence of the metabolic syndrome (MS) and its component disorders. The syndrome comprised abdominal obesity assessed by waist circumference, high fasting serum glucose (FSG), high triglyceride (TG), low high density lipoprotein-cholesterol (HDL-C) and high blood pressure. A cohort of 9,785 adults (4,707 men and 5,078 women), aged 19 to 84 years, who were free from the MS at baseline were followed for 4 years from 1998 to 2002. Using Asian criteria for abdominal obesity and reducing the threshold for FSG from ≥110 mg/dL to ≥100 mg/dL, the incidence of MS during the 4-year follow up in the MJ Health Screening Center Study in Taiwan was 12.7% (17.5% for men and 8.3% for women). The incidence of the MS in men exceeded that for women up until 50-59 years and then this gender was reversed in the older age groups pointing to pre-menopausal protection in women. The most evident manifestations of the incident of metabolic abnormalities were high FSG, high blood pressure and high TG, particularly in post-menopausal women. Baseline body mass index and age were the most significant predictors of MS for both men and women, with cigarette smoking significantly predictive in men. Incident information should inform preventive and intervention strategies in Taiwanese, both Chinese and Indigenous, more effectively than MS and its component disorder prevalences. Key Words: BMI, incidence, metabolic syndrome, metabolic abnormalities, Taiwan

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身體質量指數為1998-2002台灣人代謝症候群及其組成發生的一個主要因素

本研究以台灣一大型健檢中心會員定期健檢資料來探討代謝症候群與其組成發生的因素。研究對象為起始無代謝症候群之9,785位台灣美兆健檢中心會員,年齡介於19至84歲,於1998至2002年間有定期接受健康檢查者。代謝症候群組成包括了腹部肥胖(女性腰圍80公分,男性腰圍90公分)、高空腹血糖(100 mg/dL)、高三酸甘油酯、高密度脂蛋白偏低及血壓偏高,此5項異常中符合3項者歸為代謝症候群發生。經追蹤4年後,研究對象之代謝症候群發生率為12.7% (男性為17.5%與女性為8.3%)。男性在50-59歲之前,代謝症候群發生率大於女性,但年齡增加後則反之,顯示更年期前女性受到保護。代謝異常發生以高空腹血糖、血壓偏高與高三酸甘油酯最多,特別在更年期後的女性。在男女性中,代謝症候群的發生與起始身體質量指數及年齡有顯著相關;而在男性中,抽菸也顯著與代謝症候群的發生有關。相對於僅注意代謝症候群及其組成盛行率,台灣更應提供預防代謝症候群發生的資訊及介入措施。

關鍵字:身體質量指數、代謝症候群發生率、代謝異常、台灣。

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HPV-induced recurrent laryngeal papillomatosis: dietary fatty acid and micronutrient intakes LOUISE LOUW AND CORINA WALSH

Human papilloma virus (HPV)-induced recurrent laryngeal papillomatosis (RLP) is a chronic debilitating disease often encountered among children of poor socio-economic South African groups.  There are a few studies and limited evidence as to what extent nutrition may contribute to this disease.  To our knowledge this is the first study that gives an account of dietary FA and micronutrient intakes in RLP patients, according to food frequency questionnaires.  The dietary FA profile revealed an excessive linoleic acid (LA) intake syndrome and is also marked by high palmitic acid (PA), oleic acid (OA) and SFA intakes.  Research revealed that enhanced LA and PA drive, respectively, mitogenetic stimuli and apoptotic resistance during tumorigenesis, whist SFAs are associated with lipid rafts, the Th1 immune response and immunosuppression.  Low folate intake, a risk for HPV-infection, and low Zn intake, detrimental for lipid metabolism and immunocompetence, occurred in, respectively, 70 % and 20% RLP patients.  The poor correlations that were found in RLP patients between essential fatty acids (EFAs) and micronutrients, namely, Mg, Zn and Se, involved in lipid metabolism and immune responses, need proper clarification.  Overall, it is plausible that the diet (poor nutrition), a shift in lipid metabolism caused by HPV- infection, environmental smoke and oxidative stress, as well as extra-esophageal acid reflux with secondary inflammation in the larynx are co-factors in the etiology of laryngeal papillomatosis, and that immunocomprised patients are subjected to recurrence.  It is imperative to ensure that children with RLP receive proper nutrition and follow a healthy lifestyle to prevent disease recurrence after treatment. Key Words: Papillomatosis, fatty acids, micronutrients, immunodeficiency, immunonutrition

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HPV誘導喉頭乳瘤復發症:膳食脂肪酸及微量營養素攝取

人類乳突病毒誘發週期性的喉頭乳瘤(RLP)是一種慢性使人衰弱的疾病,好發於社經狀況較差的南非族群的兒童之間。僅有少數研究及有限的證據說明營養情況對此疾病的影響。就我們的認知,這是第一個研究,根據食物頻率問卷考慮RLP病人的膳食脂肪酸及微量營養素的攝取。膳食脂肪酸數據顯示過多的亞麻油酸(LA)攝取,棕櫚酸(PA)、油酸(OA)及飽和脂肪酸攝取也高。研究顯示較多的LA及PA,在腫瘤新生期間會分別刺激細胞分裂及阻抗細胞凋亡;而飽和脂肪酸與脂質促進Th1免疫反應及免疫力之抑制有關。低葉酸攝取是HPV感染的危險因子,而低鋅攝取,不利於脂質代謝及免疫能力,這兩者分別發生在70%和20%的受測RLP病人中。另外發現在RLP病人,必須脂肪酸攝取與脂質代謝及免疫反應攸關的微量營養素,即鎂、鋅及硒的攝取量之相關性很小,這結果需要更進一步的釐清。整體來說,飲食(較差的營養)、HPV感染引起的脂質代謝轉變、環境菸害、氧化壓力,以及因次級發炎引起的額外食道酸液回流,在喉頭乳瘤症的病因學是共因子,而免疫功能不全的病人較容易復發。因此,確定RLP的兒童在治療之後,得到適當的營養及保持健康生活型態以預防疾病的復發是必要的。

關鍵字:乳突瘤、脂肪酸、微量營養素、免疫不全、免疫營養。

 

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Last Updated: July 2008